Evaluation of a regional German interdisciplinary oral health programme for children from birth to 5 years of age

Objectives: The aim of this prospective birth cohort study was to evaluate the effect of the interdisciplinary oral health programme (OHP) for early childhood caries (ECC) in 5-year-old German children.

Material and methods: All parents of newborns (n = 1162; born 2009/2010) were visited after birth by the communal newborn visiting service of Jena, Thuringia, and advised on general and dental health. In the first year of life, children were invited to attend a dental examination in the Jena University Hospital. Participating children were included in a caries-risk-related recall system with continuous oral care over 5 years. The caries-risk assessment tool of the AAPD was used to determine the likelihood of carious lesion development and to categorize the children at low, moderate or high risk for caries. High-risk children received fluoride varnish. Families (n = 563) who gave their approval for final examination after 5 years were invited again and examined by a blinded clinician. Dental caries was scored using WHO diagnostic criteria expanded to d1-level without radiography. Children were allocated to prevention (PG) and control group (CG) and matched on the basis of age, sex, ethnicity and socio-economic status (SES).

Results: Two hundred and eighty-nine children (mean age 5.2 ± 0.7 years; 46.7 % female) were examined. Children in the PG (n = 174) showed significantly lower caries prevalence and experience (10.9 %, 0.2 ± 0.7 d_3-4mft) than children in the CG (57.4 %, 2.9 ± 3.8 d_3-4mft). Multivariate analysis found that low SES, early start of tooth brushing, supervision/regular second brush by parent, regular dental visits and duration of breast-/bottle-feeding >1 year were significantly related to d_3-4mft.

Conclusions: The OHP was an effective approach for preventing early childhood caries in preschool children.

Clinical relevance: A programme consisting of early maternal counselling, establishment of a dental home, and inclusion of the children in a caries-risk-related recall system with continuous dental care and fluoride varnish application can prevent ECC.

Trial registration: German Clinical Trials Register DRKS00003438, https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00003438.